Mail Online - Julia Manninghttps://manningblog.dailymail.co.uk/
en-GBTue, 20 Nov 2012 21:51:17 +0000http://www.typepad.com/Innocent, sick children locked in police cells – why are we not prioritising children in need?https://manningblog.dailymail.co.uk/2012/11/innocent-sick-children-locked-in-police-cells-why-are-we-not-prioritising-children-in-need.html
https://manningblog.dailymail.co.uk/2012/11/innocent-sick-children-locked-in-police-cells-why-are-we-not-prioritising-children-in-need.htmlThe most shocking headline this weekend was surely that young children are being locked up in police cells when they are suspected of being mentally ill at the rate of nearly one child a day. Freedom of Information requests revealed that 347 children were detained under the Mental Health Act...The most shocking headline this weekend was surely that
young children are being locked up in police cells when they are suspected of being
mentally ill at the rate of nearly one child a day. Freedom of Information
requests revealed that 347 children were detained under the Mental Health Act
last year; children who the police or ambulance service thought were so
mentally disturbed that they needed to be taken to a place of safety and
assessed by a psychiatrist. The trouble was that there simply weren’t enough
safe places to which children could be taken, so day after day an acutely
distressed, vulnerable and sick child ended up in a police cell where they were
totally isolated, instead of being in the reassuring presence of a qualified
professional in supportive surroundings.
<p>As with so many other illnesses, early assessment in mental
illness is crucial to finding both the right treatment and for a more rapid
rate of recovery. Imagine your child having a suspected appendicitis, being
distraught in immense pain. The paramedic then tells you that as the local
hospital’s abdominal surgeons are on an “away day” your child will be kept safe
in a police cell in the meantime! (In one of the child cases above where they
ended up in a police cell, mental health professionals were on an away day with
no cover arranged at the local hospital). It’s a ludicrous comparison and
scenario I will admit, such delays in assessment are unthinkable. However
mental illness is just as important as physical; in fact it is in many ways
unhelpful to separate the two as there are usually mental illness symptoms in
physical sickness and physical symptoms in mental illness. </p>
<p>These are not children who have done anything wrong or
criminal, they simply happen to be one of the 10% who at some point in their
childhood suffer with mental illness. Even with a severe episode of ‘psychosis’
where someone loses touch with reality, for 25% of people it’s a one-off
event.&#0160; Psychosis occurs in 3% of the
population, making it more common than other conditions such as diabetes. Three-quarters
of mental illness develops before we reach 25 years of age and overall mental
illness accounts for about 23% of all disease (compared to cancer at 15% and
heart disease at 16%) but only about 11% of the NHS budget is spent on mental
health.</p>
<p>What this research highlights again today is that we are not
resourcing mental health properly, and children’s services in particular are
failing some of the most needy. The health minister Norman Lamb spoke on the
radio yesterday about picking up with the Home Office on this issue, but he was
getting mixed up with the provision of mental health services for&#0160; young offenders (also woefully inadequate).
Mental health services for law-abiding young people are a joint responsibility
for the Department of Health and the Department of Communities and Local
Government, and although the health budget has been protected, cuts to Local
Authority budgets have resulted in 53% of Councils cutting their mental health
provision in the last year. </p>
<p>We have plenty of research that helps us predict the demand
for mental healthcare. We also know that across the board, demand on the health
budget is growing. While no politician will admit that we don’t have enough tax
revenues to fund healthcare properly, and decisions on what we prioritise in
the NHS are therefore taken by stealthy rationing, tragic occurrences such as
the incarceration of highly needy children will continue. Surely politicians
are failing some our most vulnerable children if they will not insist that
child mental health is adequately resourced, even if it means that other,
optional services are withdrawn? If there is one worthy task the new Police and
Crime Commissioners can get straight on with, it is ensuring that no innocent,
poorly child ends up in the police cells.</p>Current AffairsDMTue, 20 Nov 2012 21:51:17 +0000International Development: the chance to leave the world, not just our country, in a better placehttps://manningblog.dailymail.co.uk/2012/11/international-development-the-chance-to-leave-the-world-not-just-our-country-in-a-better-place.html
https://manningblog.dailymail.co.uk/2012/11/international-development-the-chance-to-leave-the-world-not-just-our-country-in-a-better-place.htmlOn the day when Americans are choosing which direction their country will take over the next four years, I doubt there are many who think that one of the candidates has all the answers. The best politicians are those who have considered the needs of society and want to invest...<p>On the day when Americans are choosing which direction their
country will take over the next four years, I doubt there are many who think
that one of the candidates has all the answers. The best politicians are those
who have considered the needs of society and want to invest their lives in
putting into place policy that they believe will lead to improvement. No one,
quite rightly, promises Utopia; but through refining, planning and empowering
they aim to leave their country in a better position than that in which they
found it. </p>
<p>To argue that any particular policy area isn’t working is conventional;
to argue that a whole strategy is wrong and therefore the department should be
abolished is bizarre. Imagine if Michael Gove had taken that approach:
education is failing so let’s stop funding it! But this is what we regularly
hear people proclaiming in the press about the International Development
budget. Added to this, apparently we shouldn’t, and can’t afford, to give away
money until we have ‘our own house in order’. Does anyone really think that
will ever happen? If each of us waited until we felt we could <em>afford</em> to give money away, we’d quickly
see every charity in the land fold. Visit a local food bank or talk to a
counsellor from Christians Against Poverty and it’s true, many people in
Britain are having a really hard time right now, and the correct response
should be that those of us in work should be sharing more of what we have. But
this is the same principle that means on an international level, we as a
country should share some of what we have with those in countries who are
desperately needy.</p>
<p>Reading ‘The Ringtone and the Drum’, the new book by Mark
Weston, on his travels in the three of the world’s poorest countries, one
regains some perspective on how some of the world’s poorest people are trying
to cope. He starts in Guinea-Bissau, a country that few have heard of and very
few visit. With no infrastructure, no electricity since the state power company
ran out of money in 2003 (so even government ministers have to charge their
mobiles at internet cafes which have the generators that their ministries lack),
no free healthcare, daily survival is a challenge. Along the coast in Sierra
Leone, there isn’t even a functioning hospital even if you did have the money to
pay for treatment. People walk around covered in grime and dust, not through
choice, but through no access to running water. Poverty reduces relationships
to transactions: I will only give or share if you give something back. Even
little children see their bodies as economic assets and girls expect to sell
themselves for money. He ends his journey in Burkino Faso which is at the sharp
end of the impact of climate change; heat and famine claim many lives and
orphans who survive are increasingly being exploited by Al Qeada.</p>
<p>As Mark says, the “ubiquity of individual tragedy (in West
Africa) and your close proximity to it” make it difficult to sustain any
shallow detachment. But away from this stark reality, many of us are removed and
see foreign aid as something we can’t afford. ‘The Ringtone and the Drum’
reminds us of our affluence and privilege as well as taking us on a fascinating
journey through West African history and geography. As with any policy
review, our response should not simply be to agree to keep giving aid, but to
rigorously review to whom and how are we giving? This is not about the powerful
making decisions on behalf of the poor and creating dependency, but
understanding that the poor have a huge burden of taking responsibility for <em>everything</em> in their lives, much of which
we the wealthy don’t have to e.g. growing our own food. Therefore our aid needs
to relieve some of the burden (such as providing education and healthcare) as well as giving
people productive assets (such as a cow). </p>
<p>A pound goes a long way in Africa and the Secretary of State
Justine Greening is rightly now reviewing how and to what we give. Wise investment
and an intelligent approach would not only save lives but transform communities
as economists such as MIT Professor Esther Duflo has shown. And by the way, there
is an opportunity to hear more about the need as Mark is talking about his book
at the School of Oriental and African studies on Wednesday lunchtime. </p>Current AffairsDMWed, 07 Nov 2012 00:25:51 +0000Dying to talk: why GPs discussing death should not be taboohttps://manningblog.dailymail.co.uk/2012/10/dying-to-talk-why-gps-discussing-death-should-not-be-taboo.html
https://manningblog.dailymail.co.uk/2012/10/dying-to-talk-why-gps-discussing-death-should-not-be-taboo.htmlDame Cicely Saunders is ranked alongside Aung San Suu Kyi, Dietrich Bonhoeffer, Martin Luther King and Nelson Mandella in former Prime Minister Gordon Brown’s book ‘Courage: Eight Portraits’. Dame Cicely spent eleven years thinking about how to develop a place where people who knew they were dying of cancer could...<p>Dame Cicely Saunders is ranked alongside Aung
San Suu Kyi, Dietrich Bonhoeffer, Martin Luther King and Nelson Mandella in former
Prime Minister Gordon Brown’s book ‘Courage: Eight Portraits’. Dame Cicely
spent eleven years thinking about how to develop a place where people who knew
they were dying of cancer could be looked after with holistic care, before
founding St. Christopher’s Hospice in 1967. She knew from her own experiences
of grief that medical care wasn’t enough: for people to be treated with dignity
at the end of their lives required a co-ordinated approach of pain-relief, psychological
and spiritual provision, and recognition that family and friends need to be
supported too. She transformed both the approach and attitudes to end-of-life
care, initially just for those with cancer but then extended the approach to
others too, and her method has been copied world-wide.</p>
<p>So when we hear that GPs have been encouraged
to think about which of their patients could be nearing the end of their lives,
we should be really pleased. How many stories do we hear of people not getting
the support they need when dying, people not being asked where they would like
to die, families not being asked about arrangements to provide for their loved
one as the end approaches? Apparently 35% of GPs have never initiated a conversation
with any of their patients about how they would like to be provided for as they
face death. Considering death is such a certainty, isn’t this a ridiculous
taboo? GPs are now being encouraged to proactively think through who will need
end-of-life care, so that it can be thoughtfully discussed and sensitively planned.
</p>
<p>So the last thing we need are sinister stories
about ‘death lists’ and that people are being ‘singled out’ as those who are ‘going
to die’, and the implication that this is about saving money. This is
journalism at its worst: scaremongering, damaging and disingenuous. Some of
those who were summoning up the courage to talk to their doctor about their
fears and concerns of dying now will not do so, having had the trust in their GP undermined.</p>
<p>Ironically one of my frequent complaints has
been that we don’t know which GP’s actually sign up to the <a href="http://www.goldstandardsframework.org.uk/" rel="nofollow">National Gold Standards
Framework</a> which was designed to ensure the best possible standard of care
for those nearing the end of life. As patients we should know what our local
GPs offer and when I am elderly or dying or both, I will want to be registered
with a practice that has signed up to the Gold Standard. I will want to review how
and where I will die. Predicting the timing is an innacurrate science, but at least when death begins to loom, my wishes will have been made known. Polls show that most people want those
discussions, with up to 70% wanting to die at home but the majority of us still
dying in a hospital, the modern equivalent of the Poorhouse. </p>
<p>I hope all newspapers who have run the scare stories will now run some
features on how palliative, hospice and pro-active end-of-life care have
enabled people to be treated with dignity in their final months and days. 1% of
their readership will die this year (the average annual rate), and it would be
a horrific to think that some people may die unsupported because they were too
scared to talk to their GP. Dame Cicely would be appalled.</p>Current AffairsDMFri, 19 Oct 2012 19:33:57 +0100Challenging and changing attitudes are a key legacy of these Games, and reflecting that in healthcare must be a priorityhttps://manningblog.dailymail.co.uk/2012/09/challenging-and-changing-attitudes-are-a-key-legacy-of-these-games-and-reflecting-that-in-healthcare-must-be-a-priority.html
https://manningblog.dailymail.co.uk/2012/09/challenging-and-changing-attitudes-are-a-key-legacy-of-these-games-and-reflecting-that-in-healthcare-must-be-a-priority.htmlOver the summer a few new national treasures have emerged. One of them is Clare Balding, who having articulated the thrills and spills of the Olympics on the Beeb was then seconded to Channel 4 to continue expressing our joy and pride at the Paralympics. Last night as she rounded...<p><span style="font-size: 10pt;">Over the summer a few new national treasures have emerged.
One of them is Clare Balding, who having articulated the thrills and spills of
the Olympics on the Beeb was then seconded to Channel 4 to continue expressing
our joy and pride at the Paralympics. Last night as she rounded up the final
programme she reminded us of what should be one of the lasting legacies of the
London 2012 games: a legacy of attitude. </span></p>
<p><span style="font-size: 10pt;">We’ve been challenged as a nation. Even before the games
began we saw communities across the nation come together in support of Olympic
flame bearers and felt our hearts stir. As the games opened we felt national
pride at our history of innovation and endurance; as they got underway we
experienced kindness and generosity from those involved at a level normally
only seen at times of disaster. And as we witnessed paralympians triumphing
over disaster, day after day, we were humbled and awestruck.</span></p>
<p><span style="font-size: 10pt;">The legacy of attitude that Clare referred to is up to each
one of us. When GK Chesterton answered the question to ‘what is wrong with the
world?’ with ‘I am’ he expressed a truism that we must not forget. It is down
to each one of us to honour the memory of the games with our own expressions of
kindness; our own willingness to get involved; to look for what we can achieve
and help others to achieve; to paraphrase another great man, to ask what we can
do for our country. </span></p>
<p><span style="font-size: 10pt;">We face many difficult years ahead. We think we know what we
are dealing with now, but if the Eurozone falters we could find the economic
crisis of today is only the first chapter of austerity. Yet if we start living
the legacy now, thinking about what we can do both for ourselves and for our
communities, relying less where we can on the State, then we will have an attitude
that honours the gamesmakers. Only last week a group of MPs debated <a href="http://www.publications.parliament.uk/pa/cm201213/cmhansrd/cm120906/debtext/120906-0003.htm#12090626000003" rel="nofollow" target="_self">community
hospitals</a> and how many of them benefit from volunteers, community support and
kindness. They called for a review of the ownership models, and one of the most
promising is that of mutuals. A mutual set-up involves one or more of a
combination of elements of employee ownership, co-ownership, social enterprise
and mutuality. The model promotes self-reliance and all the benefits (such a
pride, willingness to innovate and stronger community ties) of having a stake
in the organisation for which you work or volunteer. Many community hospitals
are synonymous with more holistic, compassionate care, have active
participation from the locality that they serve and promote and enable
independent living. Enabling greater involvement of a community in its own healthcare
provision is a sustainable and affirming solution to the challenges we face,
not least the reduced tax-take from the decrease in the ratio of working people to the over 70’s which is
predicted to fall dramatically from 5.3 to 1 back in 2010 to 3.7 to 1 in 2030. </span></p>
<p><span style="font-size: 10pt;">London 2012 couldn’t have happened at a better time for the
nation. It has given us momentum for believing that each of us can do more, encouraging
us to care and value caring more, and can make a contribution to our society.
This greater confidence is a good thing.</span> </p>Current AffairsDMMon, 10 Sep 2012 19:54:48 +0100Jeremy Hunt called in to give NHS TLChttps://manningblog.dailymail.co.uk/2012/09/jeremy-hunt-called-in-to-give-nhs-tlc.html
https://manningblog.dailymail.co.uk/2012/09/jeremy-hunt-called-in-to-give-nhs-tlc.htmlThe airwaves had gone quiet recently about Andrew Lansley. Whereas before many reckoned that he would be removed as Secretary of State for Health once the new NHS Act was through, increasingly people then wondered who else would want to take on this brief with the complex reorganisation underway, understood...<p>The airwaves had gone quiet recently about Andrew Lansley. Whereas
before many reckoned that he would be removed as Secretary of State for Health once the
new NHS Act was through, increasingly people then wondered who else
would want to take on this brief with the complex reorganisation
underway, understood by very few outside of the Department of Health. </p>
<p>And of
course everyone in politics knew that health was the only job Lansley wanted, and one
for which he had waited for over six years. However, Lansley has today been
replaced by Jeremy Hunt. The Prime Minister has been kind to Lansley, who is his old
boss, and given him an overarching role - Leader of the House - which
gives him the job of organising all Commons business, including health,
as well as deputising for the Prime Minister when he or his deputy
can&#39;t be there. </p>
<p>It was probably the only thing that Lansley could take
and that the PM could give which still allowed him a high profile, a
seat at the Cabinet table and the opportunity to talk about
health. Savvy.</p>
<p>
Jeremy Hunt had always been
the one people mentioned as a replacement for Lansley, but after the Sky
semi-scandal the chattering stopped. In public. However, my take on
the thinking behind his appointment is this: The PM now wants a safe
pair of hands who will spend the next 3 years listening, building
relationships, supporting clinicians in their new commissioning roles - who will
stop (let&#39;s hope) manager bashing, and be a general all-round TLC
ambassador for the NHS. He will have the mid-Staffs report to deal with;
he will need copious amounts of patience and diplomacy as the new
structures emerge; and he will need to bring his commercial wit into
play when it comes to sorting out a new payment scheme for medicines and
building confidence in the independent sector. </p>
<p>The new health secretary has his work cut out just to deal with the situation as it is, although the rising demands
and unsustainable costs mean that devising new income streams, reducing
some provision, and supporting radical new ways of delivering care cannot be ignored. Other new ideas would
probably be limited to social care and building public confidence post
mid-Staffs. No small task, but more about consistency than concepts.&#0160; </p>
<p>Interestingly, in his previous role, Hunt oversaw the support for installing super-fast broadband in England, and part of his thinking was to facilitate telehealth. With the increasing ability to skype your GP, have an appointment with a distant consultant though a video monitor, access online medical records, and see a high resolution CT scan on a laptop, this is a radical change that he should get behind. No pressure, but 1.5million NHS employees are now watching Hunt very carefully. </p>Current AffairsDMTue, 04 Sep 2012 18:49:58 +0100Patients missing appointments - maybe they never needed them?https://manningblog.dailymail.co.uk/2012/08/patients-missing-appointments-maybe-they-never-needed-them.html
https://manningblog.dailymail.co.uk/2012/08/patients-missing-appointments-maybe-they-never-needed-them.htmlIf someone doesn’t turn up for an appointment there are only a few possible reasons: they died; they forgot; transport failure or they didn’t need the appointment in the first place. The figures for the number of people not turning up for NHS appointments were revealed over the bank holiday...If someone doesn’t turn up for an appointment there are only
a few possible reasons: they died; they forgot; transport failure or they didn’t
need the appointment in the first place. The figures for the number of people
not turning up for NHS appointments were revealed over the bank holiday weekend
– <a href="http://www.guardian.co.uk/society/2012/aug/27/missed-nhs-appointments-cost-millions?newsfeed=true" rel="nofollow">one
in ten</a> people don’t attend an appointment totaling 5.5m missed
appointments in the last year. This includes appointments people have made for
themselves.
<p><a href="http://www.bbc.co.uk/programmes/p00x09ck" rel="nofollow" target="_self"></a>BBC local radio also covered yesterday the <a href="http://2020health.wordpress.com/" rel="nofollow" target="_self">forthcoming
2020health report</a> on how few people are being given electronic access to their
health records (one in 100), despite the evidence showing that patients who
take up the service usually have better health. </p>
<p>The common theme here is that NHS remains far too
paternalistic, with doctors making many decisions without involving the
patient and still regarding intimate details about an individual’s life history
(i.e. the patient’s notes) as belonging to the state. Legally notes do still
belong to the NHS, but despite the fact we have had the right to see our
records for a couple of decades, many professionals still view us as
passive recipients of care instead of active participants who should be involved
in planning and management. This includes whether we really want an appointment, or just a quick call for reassurance or leaving it to us to decide. I recently sat by a doctor’s desk in a large
London teaching hospital as he viewed his PC. He hadn’t looked up when I walked
into the room; he’d spoken to either the notes or the screen, and it was only
when I said “and I’d like a copy of my test results” that he looked at me. “Why
would you want those?” he asked abruptly as if talking to an unreasonable
child. </p>
<p>Personal electronic health records will go a long way to
enabling us to take more responsibility for our healthcare. More information
leads to greater understanding and awareness and can lead to improved health. The
proliferation of health apps show that there is a real appetite for information
and self-care. The government should be falling over itself to encourage
electronic access and approving apps as this will reduce the burden on the NHS
and go some way to reducing the 40% (according to GPs) of unnecessary
appointments, easing the difficulties experienced by some patients who have
found it harder to get an appointment because of <a href="http://www.labour.org.uk/uploads/1e7671d5-b598-9cb4-2901-c3dc962c4fe2.pdf" rel="nofollow">their
local surgery reducing their opening hours</a>. And if we really are going to
have a system that people value and includes rights, responsibilities and
redress, then we should be charged the cost of the appointment if we don’t show
up (easily done with an electronic system) which will help us decide whether we needed the appointment in the first place! </p>Current AffairsDMWed, 29 Aug 2012 12:36:48 +0100NHS International: with careful branding this should be part of our growth agendahttps://manningblog.dailymail.co.uk/2012/08/nhs-international-with-careful-branding-this-should-be-part-of-our-growth-agenda.html
https://manningblog.dailymail.co.uk/2012/08/nhs-international-with-careful-branding-this-should-be-part-of-our-growth-agenda.htmlIt was surprising to hear the government announce the launch of a new initiative yesterday to encourage NHS Trusts to expand abroad (as covered here by Tim Shipman), but only because this is already happening. Back in 2010, Andy Burnham, the then Health Minister launched NHS Global, with the explicit...<p>It was surprising to hear the government announce the launch of a new initiative yesterday to encourage NHS Trusts to expand abroad (<a href="http://www.dailymail.co.uk/news/article-2191252/NHS-hospitals-set-China-Gulf-Drive-cash-Olympic-opening-ceremony.html" rel="nofollow" target="_self">as covered here by Tim Shipman</a>), but only because this is already happening. Back in 2010, Andy Burnham, the then Health Minister launched NHS Global, with the explicit aim of generating income internationally from the NHS brand to be ploughed back into NHS care at home. He could well have been inspired by Moorfields Eye Hospital, where I did some of my training. They launched a satellite hospital in Dubai in 2007. Moorfields brought local doctors over to the UK to train them and they then went back to deliver care under the internationally renowned &#39;Moorfields&#39; brand.</p>
<p>The fact that Moorfields already had a brand however is key. &quot;NHS Eyecare&quot; (despite the pun) would not have had the same appeal. It will be the major hospitals who will have an opportunity here, often already with an internationally known brand and area of specialty such as Great Ormond Street or the Royal Marsden.The government will have to be careful about overselling the &#39;NHS&#39; tag, despite the Olympic endorsement. No one is looking forward to the Mid-Staffs inquiry report due out in the Autumn when there will be no getting away from seeing the NHS at it&#39;s worst. </p>
<p>There is another key point here - this would not be nearly so appealling for NHS Hospitals if the government hadn&#39;t already raised the private income cap. Until the 2012 Health and Social Care Act, NHS hospitals were only allowed a small fraction of their income to come from private sources. The new Act means that up to 49% of an NHS hospital&#39;s income can now come from the private sector, which includes private patients, research, support biotchnology start-ups as well as international sources. And before you start to worry - the income has to be spent in the NHS and it is illegal for any NHS patient to have their treatment delayed in preference of a private patient.</p>
<p>This policy has been supported by both the main parties and Labour should be claiming the idea as rightly their own. We should not be obsessed with all NHS income coming from the taxpayer when we know that rationing is happening now and with an ageing population demand will continue to rise. No options should be off the table when it comes to generating new income for the NHS and it is not before time that we exploit our world-class hospital brands to enhance our reputation and potentially attract more business in the UK too. As Andy Burnham pointed out back in 2010, BBC worldwide has been a huge success; added to this our universities, police and fire rescue crews have all contributed internationally and capitalised on their reputations. The healthcare industry is estimated to be worth $4 trillion worldwide. This is surely an ethical opportunity for generating more income for the NHS, exploiting our succesful hospital brands and should be part of our growth agenda.</p>
<strong></strong><br />Current AffairsDMWed, 22 Aug 2012 11:56:26 +0100Cancer is rising but so is indifferencehttps://manningblog.dailymail.co.uk/2012/08/cancer-is-rising-but-so-is-indifference.html
https://manningblog.dailymail.co.uk/2012/08/cancer-is-rising-but-so-is-indifference.htmlThere is a mixed response to today’s report in the Guardian that the number of older people living with cancer will treble by 2040. As cancer is much more prevalent in the elderly and more of us are living longer this isn’t a terribly surprising revelation. However there is a...<p>There is a mixed response to today’s report in the <a href="http://www.guardian.co.uk/society/2012/aug/20/number-older-people-cancer-treble?CMP=NECNETTXT8187" rel="nofollow">Guardian</a> that the number of older people living with cancer will treble by 2040. As cancer is much more prevalent in the elderly and more of us are living longer this isn’t a terribly surprising revelation. However there is a story within this report that is worth more consideration. The biggest increase in cancer will be experienced by women who smoke. At the moment, 319 women out of every 100,000 develop lung cancer; this is set to rise to 813 per 100,000. Most cancers are sporadic and we have no idea what the cause is, but smoking is a no-brainer: every cigarette you smoke raises your risk of developing lung cancer. So my question is this: why the indifference?</p>
<p>I once asked a friend of mine who spent 30 years as a psychiatrist what was the most significant change that he had witnessed during his time of practice. His answer was the “rise of indifference”. People seeming not to care or be concerned, about their habits, about their appearance, about the risks they took. In an age when we have all bemoaned the increasing propensity of government and institutions to be more risk-averse, many individuals seem much more inclined to both live dangerously and expose themselves (often literally when it comes to scant clothing). One reason might be that with a free NHS, people think that whatever they do, if they incur injury there is a service that will treat them and get them back to normal (known as risk-displacement). Whilst the service is free, the numbers show that the NHS can’t work miracles: in 1979 an average of just under 6 men per 100,000 of the population died from alcohol related deaths; by 2003 this had risen to nearly 16 per 100,000 and we know this to be an underestimate as if, for instance, you develop cancer from alcohol consumption, alcohol doesn’t get mentioned on your death certificate.</p>
<p>Maybe the rise is indifference is more deep-seated than risk-displacement however. Seeming not to care can go hand-in-hand with low self-esteem, or a denial of what is important to you in an effort to be part of a crowd, a response to abuse, a reflection of hopelessness or plain selfishness. In any event, it seems to me to be a negative indicator of well-being rather than a positive outcome of freedom, and in this light, maybe the crisis of poor care standards in hospitals or neglect of some children is not so surprising after all. If we don&#39;t value caring this effects both us and those around us. Human beings are relational, caring for ourselves and others is an essential part of our humanity as well as of our well-being. I don’t know if overall women have become more indifferent than men, but we should be alarmed at the increase because a society that doesn’t care ceases to be civilised. Post olympics we won’t go on feeling good if we simply remember the victories, but we will if we emulate the kind and caring volunteers. Then we can achieve an even more important result: the reversal&#0160; of indifference – and possibly prevent a few untimely deaths too.</p>Current AffairsDMMon, 20 Aug 2012 15:04:33 +0100Eighty years on and no justice for British girls subjected to FGMhttps://manningblog.dailymail.co.uk/2012/07/eighty-years-on-and-no-justice-for-british-girls-subjected-to-fgm.html
https://manningblog.dailymail.co.uk/2012/07/eighty-years-on-and-no-justice-for-british-girls-subjected-to-fgm.htmlAs long ago as 1932, the MP Colonel Wedgwood (direct descendent of the famous potter) spoke in parliament on the “horrible practice of female circumcision” that he had seen in Kenya and questioned any acceptance of “their customs...their cruelties”. It’s a practice that involves the partial to complete removal of...<p>As long ago as 1932, the MP Colonel Wedgwood (direct descendent of the famous potter) spoke in parliament on the “horrible practice of female circumcision” that he had seen in Kenya and questioned any acceptance of “their customs...their cruelties”. It’s a practice that involves the partial to complete removal of a girl’s external genitals which inevitably has a severely damaging impact on her physical, sexual and mental health.</p>
<p>Eighty years later what have we got? Two laws banning female circumcision – more commonly known as female genital mutilation (FGM) – but no prosecutions despite significant evidence that thousands of girls every year in the UK are at risk of this abusive practice. &#0160;</p>
<p>Newsnight have featured two excellent programmes over the past two evenings on the abhorrent practice of FGM. Last night they had a group of teenagers in the studio who boldly and rightly asked Minister Lynne Featherstone why FGM is not seen in the same light as child abuse. They were right to ask. If parents were having their daughter’s ears cut off I can’t believe the Prime Minister himself wouldn’t be denouncing it from the dispatch box and ordering a judicial enquiry.</p>
<p>The Newsnight programme detailed the approach in France, where apparently there have been over 100 prosecutions for FGM. There, all girls have an annual health check which includes a quick look at their genitals by a medical professional. This approach was ruled out immediately by Lynne Featherstone, but as one of the teenagers put it, all women have smear tests which are a much more invasive check, so what would be the problem with a quick visual inspection on younger girls by a nurse? More worryingly, when the discussion turned to girls being brought to England for FGM from other European countries, the Minister said that this was the first she had heard of it. Hasn’t she or her officials been reading the papers this year?</p>
<p>It seems quite clear to me that we need cultural change. The government need to get their act together, declare afresh that FGM is child abuse that will be prosecuted and direct some resources into investigation and prosecution. Any reports by health professionals or teachers of their concerns should be acted upon immediately. At the same time, community leaders in the UK need to establish new rites of passage for girls that don’t involve FGM but still initiate them into their culture and womanhood. These new rituals were reported on in The Lancet as long ago as 1998 and when in Kenya last month I came across several examples of faith-based rites-of-passage for girls that had replaced FGM.</p>
<p>The summer holidays are a prime time for FGM. Tory MP Jane Ellison initiated an excellent parliamentary debate on the subject just two weeks ago - it was a shame she wasn&#39;t on Newsnight. Girls, mostly from ethnic minorities, growing up in the UK are being betrayed if the government thinks that another discussion with officials in October is enough, which is what the Minister said she was going to do. Developing countries look to the UK and hear our talk of gender equality and intolerance of child abuse. It will remain empty rhetoric and incredibly ironic if we are left wringing our hands over this barbaric practice while they replace it with humane, gender-affirming ceremonies for girls.</p>Current AffairsDMWed, 25 Jul 2012 12:48:17 +0100Will Keith Allen's 'serious and balanced' televised drug stunt cover addiction, infection, psychosis, depression and death?https://manningblog.dailymail.co.uk/2012/07/will-keith-allens-serious-and-balanced-televised-drug-stunt-cover-addiction-infection-psychosis-depression-and-death.html
https://manningblog.dailymail.co.uk/2012/07/will-keith-allens-serious-and-balanced-televised-drug-stunt-cover-addiction-infection-psychosis-depression-and-death.htmlKeith Allen is a fine actor. He is also a popular celebrity well known for his drug use and flagrant contempt of the laws that ban the use of narcotics, to the extent that he is reported to have used his daughter Lily to help him sell drugs at Glastonbury....<p>Keith Allen is a fine actor. He is also a popular celebrity well known for his drug use and flagrant contempt of the laws that ban the use of narcotics, to the extent that he is reported to have used his daughter <a href="http://www.bbc.co.uk/news/entertainment-arts-18855311" rel="nofollow" target="_blank">Lily to help him sell drugs at Glastonbury.</a></p>
<p>Keith has gone on the defensive after it was revealed that he is involved in a ‘serious and balanced’ Channel 4 ‘documentary’ purporting to show reactions of participants to controlled substances, that is illegal drugs. He said on ITV1′s This Morning: “If you think that I’m glamorising the taking of drugs by spending an hour and 20 minutes for two consecutive Mondays in an MRI scanning machine then you’re insane.” He went on to describe the programme as a ‘forensic analysis’ investigating drugs.</p>
<p>I still stand by my <a href="http://www.dailymail.co.uk/news/article-2174104/Lily-Allens-father-Keith-ecstasy-TV-Backlash-Channel-4s-drugs-stunt.html">original comments</a>. This is reckless and pointless because the whole reason that we have the 1971 Misuse of Drugs Act is that we had built up a repository of evidence showing the detrimental effects of the non-medical use of various groups of drugs. We have archives of research covering both the positive medical benefits of drugs and their side effects, and the drastic results of drug misuse. This research isn’t at a standstill as we still have much to learn about modes of action and transmission, but it’s laughable to suggest that this is a serious scientific study even with Professor David Nutt of Imperial College at the helm. For starters, the exclusion criteria of a study always includes an individual’s medical history, and former use of illegal substances that have known permanent effects on the body would rule out a candidate, including Mr Allen.</p>
<p>It was Professor Nutt who previously suggested horse-riding is more dangerous than taking ecstasy. He may be right when it comes to the in-the-moment risk, but his analogy then crashes. Once you get off a horse the risk is over; with drugs the risks endure, and this is another reason why a programme looking at the initial reaction to drug taking is pretty pointless. The reactions from drugs can last a lifetime, vary between individuals, between the strength of drug taken (not usually known on the street) and between drugs. Whilst the initial euphoria can be impressive (and having had medical dia-morphine, more commonly known as heroin, as my pain-killer after a botched epidural I can testify to the ‘high’) will this programme be capturing the down-stream wash of physical and mental collapse?</p>
<p>Quite how this programme’s content contributes to the apparent discussion of a “very calm look at the question of legality and illegality of drugs” is trumped up justification. Maybe the addiction, collapsed veins, bacterial infections, abscesses, high blood pressure, muscle spasm, blurred vision, arthritis, psychosis, depression and death won’t feature as they aren’t the initial ‘reactions’ experienced?</p>
<p>From what we know of this programme, I can’t quite see it as anything other than a traditional Channel 4 publicity stunt. And I note that the Home Office spokesman said: &#39;Any unlicensed possession of Class A drugs is a criminal offence, unless this is done under authorisation from the Home Office,&#39; without saying that this programme did have the authorisation. Hmmm.</p>Current AffairsDMTue, 17 Jul 2012 21:20:51 +0100